The article begins with identifying the problem – namely that there are many people who die in the intensive care units of hospitals – who would rather die at home. Medical doctors are trained and programmed to do everything possible to keep their patients alive. That is a good thing! On the other hand, there are undoubtedly some situations where providers have an incentive to provide more services even though everyone knows that the services are not going to heal the patient.
The most important thing that someone can do is an advance health care directive. In that document, the individual has the opportunity to select a health care agent to make medical decisions on his/her behalf. When I prepare an advance health care directive for a client, I insist on a minimum of two choices and prefer three. The agent can be anyone, but is usually a spouse. If there is not a spouse, then a child. If there is not a child, then someone else with whom the individual is close.
Some clients ask me if they can make two people “co-agents”. I explain to them that it is best to select one person. That person can consult with anyone he or she desires. Frequently they do.
The second purpose of an advance health care directive is for the patient to set forth his desires concerning whether or not he wants life support if he is in an irreversible condition. The vast majority of clients think alike concerning this, but as I stress to everyone there is no right or wrong.
It is extremely helpful to give copies of the advance health care directive to your doctor, and to the people you list as health care agents. The document is of absolutely no use if it is only found after the individual who executed it has succumbed. In any case, it is always beneficial to plan ahead, and when your health care decisions are at stake it is vital to have the proper documents in place.